Hi, I'm Terel Anderson, the dietitian here at Logan Regional Hospital
and today we're doing a class on nutrition after pregnancy.
You're probably wondering why we're talking about nutrition now that you've finished your pregnancy.
You should be off the hook, you should be able to do what you want,
but we've found that there are some things you can do in between pregnancies that affect your
risk for having a low birth weight or preterm infant in the future.
The reason we do not want to have a low birth weight or preterm infant is that these infants,
depending on how early they come, can have long-term disabilities such as blindness or cerebral palsy
and the bill is extremely expensive as they spend months in the NICUs.
So here are a few things we can do to decrease your risk for having a low birthrate or preterm infant.
We're gonna focus on making sure you have adequate iron, folic acid, and calcium,
and making sure you're a healthy weight going into your next pregnancy.
Folic acid is probably the most important thing we're going to talk about today.
It is involved in the closing of the brain in the spinal column in the very first month of pregnancy.
This is kind of the problem; it happens before you miss your first period, so you do not know you're pregnant.
If you wait till you know you're pregnant to start folic acid, you've missed the boat.
So I tell all women: if you have a uterus and it's attached to ovaries and they're functioning,
you need to have a folic acid supplement.
Your prenatal will totally cover this; your prenatal has adequate folic acid in it.
If this irritates your stomach, you may take a general multivitamin supplement,
just make sure it has 400 to 600 micrograms of folic acid in it.
The next thing we're going to talk about is calcium.
Now calcium does not affect your risk for having a low birth weight or preterm infant,
but I feel it's very important so I included it in this.
The baby has pulled from your bones in order to develop theirs throughout your pregnancy,
and while breastfeeding this will continue
Your body is amazing and it compensates by absorbing more calcium and laying it down on your bones
faster than any other time in your adult life.
We need to take advantage of this.
You need three to four cups of milk or yogurt a day.
If you are unable to achieve this, due to maybe an allergy or you're lactose intolerant,
you will need to add a calcium supplement in.
Keep in mind that you're gonna absorb the calcium better from the milk or yogurt but we do what we need to do.
So let's start with if you're getting two cups of milk or yogurt a day, you need to add one calcium supplement in.
You want one that has vitamin D in it, and usually they're about 500 to 600 milligrams.
If you are getting no calcium in your diet from milk or yogurt,
you should add in two supplements a day taken at different times.
Your body can only absorb about 500 milligrams at a time.
Now we're gonna talk about iron. Iron is a very important nutrient.
It's the part of your red blood cells that binds to the oxygen in your lungs and carries that out to the rest of your body.
If you are low in iron, it is very difficult to oxygenate the rest of your body
so it can do the things it need to do, including grow a baby
So if your body's low in iron, it's gonna be low in this oxygen.
When a woman gets pregnant, her blood volume gradually increases by about a third,
so you need to make a third more red blood cells, and you need extra stores to do that.
Right now, moms, you just had a baby and you are low in iron from blood loss.
We need to get you from this point that is deficient, to a place with good stores before you become pregnant again.
How are we gonna do this? First of all, your prenatal vitamin has iron in it and that is a good source.
Second, depending on how much blood you lost,
your doctor may prescribe an additional iron supplement for you to take.
Third, you can get iron from the food you eat.
The best source of iron is called heme iron and it comes from animal products,
such as meat, fish, chicken, pork - those are all good sources of iron.
If you are a vegetarian, you should see your dietitian.
It is a little more challenging to meet your iron needs but not impossible.
Last of all, we just talked about calcium and how important it is,
but calcium and iron compete, so that if you have a lot of calcium it will block your iron absorption.
So this is why we tell you not to take your prenatal supplement with milk.
Ideally, you'll take that with a half a cup of juice. The vitamin C in the juice will enhance the iron absorption.
All you need is a half a cup, though; you don't need a large amount of juice.
The last thing we're gonna focus on is going into pregnancy at a healthy weight.
Going into pregnancy overweight causes a lot of problems from gestational diabetes, to hypertension, and even stillbirth.
Going into pregnancy underweight also causes problems in growth and weight gain of the baby.
So we want to go into pregnancy at an ideal weight,
which I know is a little bit easy for me to say and hard for you to do. So we have a few tips to help you.
First of all, Medicaid and SelectHealth are covering nutritional counseling postpartum to come in and see the dietitian.
We go over your diet, we make sure you're getting what you need for breastfeeding,
and yet we set up a plan that you'll achieve that healthy weight.
For some women, that means making sure we lose weight;
for some women they have a hard time maintaining their weight while they're breastfeeding,
and we set up a plan to get adequate calories.
Now, it took some time to put this weight on and Mother Nature knew that breastfeeding takes more calories than pregnancy,
so you have some additional stores coming out of your pregnancy.
This is so that you are able to supplement those extra calories from your body to meet your breastfeeding needs.
If you are in your skinny jeans and have lost all this weight by next week or even the end of the month,
you have no stores to help support your breastfeeding caloric needs.
So this should come off gradually over the next six to nine months.
There is no big hurry but we want nice, healthy lifestyle changes.
Okay, a couple quick tips: you're gonna be hungry, you're gonna be up in the middle of the night, and you're gonna be tired.
For me, this meant I ate a lot of Oreos and that did not facilitate a healthy weight loss.
So you need to plan ahead and know that you're gonna be in this situation.
Have healthy snacks on hand that are easy to grab.
Things like low-fat yogurt, string cheese, fresh fruit that's cut up, some vegetables, maybe your favorite whole grain cracker.
It's harder to make good nutrition choices when you're hungry,
so it's important to have things that you like around that are nutritious.
Last of all, watch what you're drinking. You can get a lot of calories in very quickly in liquids.
After you get your milk and your half a cup of juice,
the rest of your liquids should be non-caloric: water, maybe some Crystal Light.
If you're drinking a lot of extra juice, soda pop, or even things like chocolate milk,
you could drink all your calories and not even notice and be hungry still.
Okay, let's finish up with calorie needs.
During pregnancy, your calorie needs increase by about 300 calories. Breastfeeding is 500 calories.
Women that breastfeed burn more calories in a day sitting on the couch breastfeeding than I do in my complete workout,
so it's kind of a nice advantage of breastfeeding.
Last off all, 80 percent of women lose weight while breastfeeding; 20 percent will not.
If this is you, do not panic.
Focus on your healthy eating and getting exercise and then as you stop breastfeeding,
your appetite should return to normal and that weight should come off.
Finally, we have a picture here of the new plate model.
Do you remember the food guide pyramid you learned in school? They've changed it.
The new plate model is: half your plate is fruits and vegetables, the other half is protein, grain, and milk.
The take-home message from this is half your plate should be fruits and vegatables,
and the American diet does not look like this unless you count French fries as a vegetable, which we really don't.
Thank you for listening.